Clinically important traumatic brain injuries in children's sports: A prospective PREDICT cohort study

Abstract

Background: Sports-related head injuries (HIs) are frequent in children. There are few large-scale assessments correlating type of sport and severity of injury in Emergency Department (EDs) presentations. Objective: To describe the outcomes of sports-related HIs in a large cohort of patients presenting to EDs in Australia and New Zealand. Methods: Planned secondary analysis of a prospective observational study of children who presented with a sports-related HIs at 10 Australian/New Zealand paediatric EDs. We assessed epidemiology, clinical characteristics, and outcome of clinically important traumatic brain injury (ciTBI) (death, neurosurgery, intubation > 24 h and admission >2 d with abnormal CT). Relative risk (RR) for ciTBI was calculated for individual sports. Results: Of 9,199 patients with HIs aged 5 to <18 years, 3,177 (34.5%) had sports related HIs. 2482 (78.0%) were male. 524 (16.5%) underwent neuroimaging, 64 (2.0%) had traumatic brain injury on CT and 45 (1.4%) ciTBI. Sports categories were high speed (1088, 34.3%), contact (1032, 32.5%), ball sports (495, 15.6%), club/bat (239, 7.5%), water (230, 7.2%), dance related (63, 2.0%) and racket sports (30, 0.9%) with ciTBI in 36 (3.3%) high speed, 6 (2.5%) club/bat and 3 (0.3%) contact sports and none in other sports. For individual sports RRs for ciTBI were horse riding 5.9 (2.5-14.1), bike riding 4.4 (2.6-7.7), skateboarding 3.8 (1.7-8.5), hockey 2.1 (0.5-8.9), football 0.3 (0.0-2.4), rugby 0.23 (0.0-1.7). Conclusions: Paediatric sports-related HIs frequently present to EDs. However, ciTBIs are rare with higher rates in horse riding, bike riding and skateboarding.L6221672462018-05-22 <br />